Sexual Quality of Life in Patients with Axial Spondyloarthritis in the Biologic Treatment Era

Author's accepted manuscript.This is a pre-copyediting, author-produced PDF of an article accepted for publication in The Journal of Rheumatology following peer review. The definitive publisher-authenticated version Berg, K. H., Rohde, G., Prøven, A., Benestad, E. E. P., Østensen, M. & Haugeberg, G. (2019). Sexual Quality of Life in Patients with Axial Spondyloarthritis in the Biologic Treatment Era. The Journal of Rheumatology, 46(9), 1075-1083 is available online at: https://www.jrheum.org/content/46/9/1075.Objective. To examine the relationship between demographics, disease-related variables, treatment, and sexual quality of life (SQOL) in men and women with axial spondyloarthritis (axSpA). Methods. AxSpA patients were consecutively recruited from 2 rheumatology outpatient clinics in southern Norway. A broad spectrum of demographics, disease, treatment, and QOL data were systematically collected. SQOL was assessed using the SQOL-Female (SQOL-F) questionnaire (score range 18–108). Appropriate statistical tests were applied for group comparison, and the association between independent variables and SQOL-F was examined using multiple linear regression analysis. Results. A total of 360 (240 men, 120 women) axSpA patients with mean age 45.5 years and disease duration 13.9 years were included. Seventy-eight percent were married/cohabiting, 26.7% were current smokers, 71.0% were employed, 86.0% performed > 1-h exercise per week, and 88.0% were HLA-B27–positive. Mean (SD) values for disease measures were C-reactive protein (CRP) 8.5 (12.1) mg/l, Bath Ankylosing Spondylitis Disease Activity Index 3.1 (2.1), Bath Ankylosing Spondylitis Global Score (BAS-G) 3.8 (2.5), Bath Ankylosing Spondylitis Functional Index 2.7 (2.2), and Health Assessment Questionnaire 0.6 (0.5). The proportion of patients using nonsteroidal antiinflammatory drugs was 44.0%, synthetic disease-modifying antirheumatic drugs (DMARD) 5.0%, and biologic DMARD 24.0%. Mean (SD) total sum score for SQOL was 76.6 (11.3). In multivariate analysis, female sex, increased body mass index, measures reflecting disease activity (BAS-G and CRP), and current biologic treatment were independently associated with a lower SQOL. Conclusion. Our data suggest that inflammation in patients with axSpA even in the biologic treatment era reduces SQOL.acceptedVersio

Working as a nurse in community health services during Covid-19: a qualitative study

publishedVersio

Baccalaureate nursing students’ experiences of how the COVID-19 pandemic infuenced learning – a mixed method study

Background The COVID-19 pandemic mandated the reconstruction of educational programs globally. For nursing students in need of practical learning and training as a part of their curriculum, the pandemic also caused restrictions and alterations in practical placements and limited access to simulation training at campuses. The aim of this study is therefore, to describe and explore how the COVID- 19 pandemic influenced baccalaureate nursing students’ experiences of learning and their social life as a student. Method We used a mixed method study design including quantitative data from one of the universities (University of Agder) from a national Norwegian survey of baccalaureate nursing students and qualitative data from focus-group interviews from the same university. The quantitative survey included 396 baccalaureate nursing students (response rate, 46%). We arranged five focus groups with a total of 23 students (15 females and 8 males). The students took part in one of the focus-group interviews. The quantitative data were analyzed using chi-square test for categorical data and ANOVA tests for continuous data, while the qualitative data were analyzed using Systematic Text Condensation and an editing analysis style. Results Most students (70%) were concerned about the quality of the education program. In clinical placement, 83% of students had cared for patients with confirmed COVID-19 or unclear COVID-19 status. The qualitative data revealed three main themes: missing the social dimension of learning; worries and challenges in clinical placement; and experiencing normal instructive days in clinical placement. The general picture emerging from our analysis is the importance of social interactions for learning. Conclusion As the COVID-19 pandemic continues, our findings of students’ worries about the quality of the education program and not reaching learning outcomes must be taken into consideration. Social interaction is considered crucial and fundamental for student learning. A follow-up study following baccalaureate completion is necessary to explore the consequences over time of disrupted education.publishedVersio

Records in a changing world

In the context of this paper, a record is an entry in a sequence of random variables (RV's) that is larger or smaller than all previous entries. After a brief review of the classic theory of records, which is largely restricted to sequences of independent and identically distributed (i.i.d.) RV's, new results for sequences of independent RV's with distributions that broaden or sharpen with time are presented. In particular, we show that when the width of the distribution grows as a power law in time $n$, the mean number of records is asymptotically of order $\ln n$ for distributions with a power law tail (the \textit{Fr\'echet class} of extremal value statistics), of order $(\ln n)^2$ for distributions of exponential type (\textit{Gumbel class}), and of order $n^{1/(\nu+1)}$ for distributions of bounded support (\textit{Weibull class}), where the exponent $\nu$ describes the behaviour of the distribution at the upper (or lower) boundary. Simulations are presented which indicate that, in contrast to the i.i.d. case, the sequence of record breaking events is correlated in such a way that the variance of the number of records is asymptotically smaller than the mean.Comment: 12 pages, 2 figure

PrPSc spreading patterns in the brain of sheep linked to different prion types

Scrapie in sheep and goats has been known for more than 250 years and belongs nowadays to the so-called prion diseases that also include e.g. bovine spongiform encephalopathy in cattle (BSE) and Creutzfeldt-Jakob disease in humans. According to the prion hypothesis, the pathological isoform (PrPSc) of the cellular prion protein (PrPc) comprises the essential, if not exclusive, component of the transmissible agent. Currently, two types of scrapie disease are known - classical and atypical/Nor98 scrapie. In the present study we examine 24 cases of classical and 25 cases of atypical/Nor98 scrapie with the sensitive PET blot method and validate the results with conventional immunohistochemistry. The sequential detection of PrPSc aggregates in the CNS of classical scrapie sheep implies that after neuroinvasion a spread from spinal cord and obex to the cerebellum, diencephalon and frontal cortex via the rostral brainstem takes place. We categorize the spread of PrPSc into four stages: the CNS entry stage, the brainstem stage, the cruciate sulcus stage and finally the basal ganglia stage. Such a sequential development of PrPSc was not detectable upon analysis of the present atypical/Nor98 scrapie cases. PrPSc distribution in one case of atypical/Nor98 scrapie in a presumably early disease phase suggests that the spread of PrPSc aggregates starts in the di- or telencephalon. In addition to the spontaneous generation of PrPSc, an uptake of the infectious agent into the brain, that bypasses the brainstem and starts its accumulation in the thalamus, needs to be taken into consideration for atypical/Nor98 scrapie

CHASE-PL Climate Projection dataset over Poland - Bias adjustment of EURO-CORDEX simulations

The CHASE-PL (Climate change impact assessment for selected sectors in Poland) Climate Projections – Gridded Daily Precipitation and Temperature dataset 5 km (CPLCP-GDPT5) consists of projected daily minimum and maximum air temperatures and precipitation totals of nine EURO-CORDEX regional climate model outputs bias corrected and downscaled to a 5 km  ×  5 km grid. Simulations of one historical period (1971–2000) and two future horizons (2021–2050 and 2071–2100) assuming two representative concentration pathways (RCP4.5 and RCP8.5) were produced. We used the quantile mapping method and corrected any systematic seasonal bias in these simulations before assessing the changes in annual and seasonal means of precipitation and temperature over Poland. Projected changes estimated from the multi-model ensemble mean showed that annual means of temperature are expected to increase steadily by 1 °C until 2021–2050 and by 2 °C until 2071–2100 assuming the RCP4.5 emission scenario. Assuming the RCP8.5 emission scenario, this can reach up to almost 4 °C by 2071–2100. Similarly to temperature, projected changes in regional annual means of precipitation are expected to increase by 6 to 10 % and by 8 to 16 % for the two future horizons and RCPs, respectively. Similarly, individual model simulations also exhibited warmer and wetter conditions on an annual scale, showing an intensification of the magnitude of the change at the end of the 21st century. The same applied for projected changes in seasonal means of temperature showing a higher winter warming rate by up to 0.5 °C compared to the other seasons. However, projected changes in seasonal means of precipitation by the individual models largely differ and are sometimes inconsistent, exhibiting spatial variations which depend on the selected season, location, future horizon, and RCP. The overall range of the 90 % confidence interval predicted by the ensemble of multi-model simulations was found to likely vary between −7 % (projected for summer assuming the RCP4.5 emission scenario) and +40 % (projected for winter assuming the RCP8.5 emission scenario) by the end of the 21st century. Finally, this high-resolution bias-corrected product can serve as a basis for climate change impact and adaptation studies for many sectors over Poland. The CPLCP-GDPT5 dataset is publicly available at https://doi.org/10.4121/uuid:e940ec1a-71a0-449e-bbe3-29217f2ba31d